Equine Assisted Therapy

Equine assisted therapy is an umbrella term for structured sessions in which horses are part of a therapeutic, rehabilitative, or learning plan. It covers several different things. Hippotherapy is a physical, occupational, or speech therapy strategy in which a licensed therapist uses the movement of a horse to work on posture, balance, and coordination. Therapeutic riding teaches riding skills to people with disabilities, led by instructors trained in adaptive riding. Equine-assisted psychotherapy and learning work with horses on the ground, often with a mental health professional and an equine specialist together.

People come for many reasons: movement and balance goals linked to cerebral palsy, multiple sclerosis, stroke, or aging, or emotional goals such as coping with trauma, anxiety, or stress. Many also value the quiet, outdoor setting and the experience of building trust with a large, sensitive animal. The horse is not a cure and is not a substitute for a clinician. It is part of a plan led by trained people, with the horse's welfare as important as the person's.

The research is stronger for some uses than others. Reviews of hippotherapy report gains in balance and gross motor function, particularly for children with cerebral palsy, while evidence for mental health benefits comes largely from small studies with a high risk of bias. This is a human-wellbeing practice built on the human-horse relationship, and it is separate from treatments given to horses themselves.

Using horses for rehabilitation has early roots, and an academic review dates the first known study of riding in people with disabilities to Chassaigne in 1870. The modern field is usually traced to Lis Hartel, a Danish dressage rider who had polio and won an Olympic silver medal at Helsinki in 1952, which drew medical attention to riding as rehabilitation. Therapeutic riding centers spread across Europe, and in the 1960s reached the United States and Canada. In 1969 the North American Riding for the Handicapped Association (NARHA) was founded at a meeting in Middleburg, Virginia, led by Lida McCowan and Alexander Mackay Smith.

Hippotherapy developed along a separate, clinical path. According to the American Hippotherapy Association, in 1987 a group of 18 American and Canadian therapists traveled to Germany to study it and began a standardized curriculum, and it became the first section of NARHA in 1993. NARHA was renamed PATH International (Professional Association of Therapeutic Horsemanship) in 2011, a change that reflected a broader field that now includes unmounted groundwork and programs for learning and mental health. Today PATH International certifies instructors and accredits centers, and the American Hippotherapy Association supports therapist training. Sources differ on some dates, and regulation varies by country and state.